钬激光内切开联合瘢痕电切术治疗复杂性尿道狭窄的疗效评估  

Effect evaluation of transurethral incision by holmium: YAG laser combined with cicatrization electrocision for complex urethrostenosis

作　　者：杨煜 周永兴 

机构地区：[1]云南省泸西县人民医院泌尿外科,云南泸西652400

出　　处：《中国医药科学》2013年第19期199-201,共3页China Medicine And Pharmacy

摘　　要：目的对冷刀尿道内切开联合瘢痕电切术和钬激光内切开加瘢痕电切术治疗复杂性尿道狭窄的临床疗效进行对比评估。方法记录监测78例复杂性前或后尿道狭窄或尿道闭锁、行冷刀尿道内切开加瘢痕电切术和钬激光内切开联合瘢痕电切术患者术中、术前的相关临床指标并进行统计学分析,对比分析两组的临床疗效。结果复杂性前尿道狭窄的36例患者,用两种方法实施手术,相关临床指标均差异无统计学意义;复杂性后尿道狭窄的42例患者用两种方法实施手术,均无阴茎勃起功能障碍病例发生,在治愈率方面也差异无统计学意义,但钬激光内切开联合瘢痕电切术治疗复杂性后尿道狭窄或闭锁手术时间短、术中出血量少,尿道扩张次数少,术后复发率低,术后恢复快。结论钬激光内切开联合瘢痕电切术和冷刀内切开联合瘢痕电切术在治疗复杂性前尿道狭窄或闭锁时差别不明显;但在治疗复杂性后尿道狭窄或闭锁在很多临床指标上存在优势,值得推广应用。Objective To compare and evaluate the clinical effects of transurethral incision by cold knife combined with cicatrization electrocision and transurethral incision by holmium： YAG laser combined with cicatrization electrocision for complex urethrostenosis. Methods The relevant clinical indexes of 78 cases with complex anterior or posterior urethrostenosis or urethratresia underwent transurethral incision by cold knife combined with cicatrization electroeision and transurethral incision by holmium： YAG laser combined with cicatrization electrocision during preoperation and intraoperation were monitored,recorded and statistically analyzed. The clinical effect of two groups were compared and analyzed. Results There were not statistical difference in the relevant clinical indexes between two kinds of surgery methods for 36 patients with complex anterior urethrostenosis. There were not statistical difference in the curing rate between two kinds of surgery methods for 42 patients with complex posterior urethrostenosis, and no erectile dysfunction cases happened,but transurethral incision by holmium： YAG laser combined with cicatrization electrocision for complex posterior urethrostenosis or urethratresia had shorter operation time, less intraoperative amount of bleeding, less number of urethral expansion, lower postoperative recurrence rate and more rapid postoperative recovery. Conclusion The difference of transurethral incision by holmium： YAG laser combined with cicatrization electrocision and transurethral incision by cold knife combined with cicatrization electrocision is not obvious for complex anterior urethrostenosis or urethratresia, but transurethral incision by holmium： YAG laser combined with cicatrization electrocision has great advantages in many clinical indicators for complex posterior urethrostenosis or urethratresia,and which is worthy of wide application.

关 键 词：尿道狭窄或闭锁 钬激光内切开 冷刀尿道内切开 瘢痕电切术 

分 类 号：R699[医药卫生—泌尿科学]